Take A Short Survey
‘Please ensure you are contactable within the next 48 hours where our agents will contact you and further discuss your application
Free Storage Heaters- Survey
Step 1 of 11
9%
Do You ( Or Someone Living At The Property ) Receive A Benefit ?
*
Yes I Receive a Benefit
No Benefits - NOT ELIGIBLE
Which Benefit Do You Receive?
*
DLA / PIP
Pension Credit Guarantee
Universal Credit
Attendance Allowance
Tax Credits
Job Seekers Allowance - Income Related
Income Support
Carers Allowance
Employment Support Allowance - Income Related
How Old Are Your Current Heaters ?
*
Over 10 Years Old
Over 20 Years Old
Unsure
When Was Your Loft Insulated ?
*
Unsure - I Would Like A Free Check
Loft Was Insulated A Few Years Ago
Has Been Insulated Recently - Is 300mm Deep
Loft Insulation Is Required To Be 300 mm Deep To Meet Current Standards.
What Is Your Housing Status?
*
Home Owner
Private Tenant
Landlord
Shared Ownership
Council Tenant - NOT ELIGIBLE
What Is Your Property Type*
*
Top Floor Flat With Loft
Mid / Ground Floor Flat
Semi Detached House
Terraced House
Semi Detached Bungalow
Detached Bungalow
Detached House
How Many Bedrooms Do You Have ?
*
1 Bedroom
2 Bedrooms
3 Bedrooms
4+ Bedrooms
Your Full Name
*
Benefits Claimant Name
Your Date Of Birth
*
Benefits Claimants Date Of Birth
Ist Line Of Address
*
Please Enter Your Postcode
*
Your Phone Number
*
2nd Phone Number / Email Address
*
What Is Your Main Heating ?
*
Electric Storage Heaters
Gas Boiler & Radiators
Electric Portable Heaters
No Heating System Present
Best Time Of The Day To Call You
*
Any Time
Morning
Afternoon
Early Evening
Landlord Name & Phone Number ( Private Tenants Only)
Landlord Permission Is Required For Free Grant Applications
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